More insurers threatening not to pay for non-emergent care

[RustedFox]

So basically you're saying you're willing to see them for free. If insurance doesn't pay, the majority of patients won't pay either.

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What I mean to say is not that I am willing to work for free (yes, we're all painfully aware of the unfunded mandate that is EMTALA), but that *something* has to discourage the "redness around belly button ring site" and "grandma just didn't want to poop while in the hurricane shelter for 3 days" visits.

Both are examples from yesterday's shift.

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[vm26]

Quote function is broken on desktop version....

What I mean to say is not that I am willing to work for free (yes, we're all painfully aware of the unfunded mandate that is EMTALA), but that *something* has to discourage the "redness around belly button ring site" and "grandma just didn't want to poop while in the hurricane shelter for 3 days" visits.

Both are examples from yesterday's shift.

In certain states Anthem is also refusing to pay for outpatient imaging performed at hospital owned facilities and would rather steer these patients to free-standing imaging sites since reimbursement is substantially lower (particularly for the technical fee of an examination). I get the economic rationale but this is potentially problematic for certain patients (oncology pts with multiple scans that require having multiple priors with their reports). I'm sure hospitals will come up with some counter strategy since outpatient imaging revenue is substantial.

On a side note I guess these insurance companies don't fear a single payor system since they have no trouble implementing policies that will antagonize patients/public/physicians/hospitals etc

 

[bravotwozero]

On a side note I guess these insurance companies don't fear a single payor system since they have no trouble implementing policies that will antagonize patients/public/physicians/hospitals etc

Oh believe me, they do. They've spent billions putting politicians in their back pockets and lobbying against single payer. The state of California has a democratic supermajority and they still torpedoed universal healthcare there. This is not a coincidence.

We might end up eating it if we get single payor, but health insurance companies will be annihilated. And that's the one thing I will look forward to, because there's nothing more that I would like to see.



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[vm26]

Oh believe me, they do. They've spent billions putting politicians in their back pockets and lobbying against single payer. The state of California has a democratic supermajority and they still torpedoed universal healthcare there. This is not a coincidence.

We might end up eating it if we get single payor, but health insurance companies will be annihilated. And that's the one thing I will look forward to, because there's nothing more that I would like to see.



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I'm starting to look at things from another perspective. Maybe the insurance companies see single-payor as inevitable in next 5-10 years and are just trying make as much as possible

 

[Status Sciaticus]

I think he was pointing out that the "people" are usually not punished as they will quite often refuse to pay their bill. Thus the only one getting punished is the doctor/group/hospital. Never the insurer or the patient.

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In a way they do. They dont pay, they go into collections, they get their assets seized, their credit gets screwed, their payments get garnished...

 

[Hercules]

In a way they do. They dont pay, they go into collections, they get their assets seized, their credit gets screwed, their payments get garnished...

Oh...you must be taking care of patients who have payments to garnish and credit to screw... In my experience the patients that come in with the most absurd non-emergent complaints tend to be the ones who have neither of those. You can't take away what they don't have and thus this idea generates no consequences for them.

 

[Status Sciaticus]

Oh...you must be taking care of patients who have payments to garnish and credit to screw... In my experience the patients that come in with the most absurd non-emergent complaints tend to be the ones who have neither of those. You can't take away what they don't have and thus this idea generates no consequences for them.

Thats why you put them on provisional insurance or help them get medicaid so you can atleast get something back.

 

[Apollyon]

Oh...you must be taking care of patients who have payments to garnish and credit to screw... In my experience the patients that come in with the most absurd non-emergent complaints tend to be the ones who have neither of those. You can't take away what they don't have and thus this idea generates no consequences for them.

Exactly - when exactly no ****s are given about paying bills or credit or any of that happy horse****, it don't even matter. They ain't buying no new car, house, boat, or anything else. We're just a bunch of turds that work for free, for thankless, shiftless, self centered citizens that have zero perspective, and no desire to change that.

Don't even ask me about a "basic monthly income". Mark Zuckerberg thinks, if you give people $1k/month, they'll be entrepreneurial and be willing to create. Meanwhile, back in the real world, that grand a month is more butts and liquor and pot.

It's the same as 30 years ago in "Doonesbury" - an economist says to Mark, "you saved $26 - what do you do?" Mark says, "I don't know - dinner and a movie?" And the economist sputters and says, "No, no, no, you invest in a steel company!"

Yeah, doesn't work. Didn't then, doesn't now.